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NY A00879

Bill

Status

Vetoed

12/30/2022

Primary Sponsor

Richard Gottfried

Click for details

Origin

Assembly

2021-2022 General Assembly

AI Summary

  • Removes the distinction between Title One and Title Two clinical peer reviewer requirements, applying a single definition across all utilization review and external appeal proceedings.

  • Requires physicians serving as clinical peer reviewers to possess a current non-restricted license under Article 131 of the Education Law and have five years of specialty experience.

  • Requires non-physician health care professionals to possess current licensure or certification under Title Eight of the Education Law and have five years of specialty practice experience.

  • Establishes specific qualifications for peer reviewers evaluating substance use disorder treatment and mental health conditions, requiring specialization in behavioral health and relevant treatment experience.

  • Requires non-physician clinical peer reviewers to be clinically supported by a physician with a current valid non-restricted medical license where applicable to their scope of practice.

Legislative Description

Relates to the definition of a clinical peer reviewer by clarifying that such term shall be applicable for the entire utilization review and external appeal article and means either a physician or a health care professional with certain qualifications.

Last Action

tabled

12/30/2022

Committee Referrals

Health3/9/2022
Health1/6/2021

Full Bill Text

No bill text available